Uterine myomas: pelviscopic treatment.
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Biomedical subjects
Publications and source records attributed to B Andrei.
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The authors illustrate the present possibilities of operative pelviscopy with particular regard to its indications and to the surgical technique. The endoscopic technique can today be applied in around 70% of benign affections of the female genital apparatus. Most authors agree that ovarian cysts, adhesions, ectopic pregnancies, and myomas of the uterus are, within certain limits, treatable electively with endoscopic technique; reservations still prevail in the case of hysterectomy and serious doubts in that of pelvic lymphadenectomy. Pelviscopy has proved to be both useful and safe; indeed, out of 372 operations carried out by the authors, only three had to be converted, and no complications were ever observed requiring either a laparotomy or a further pelviscopy.
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Our pelviscopic operative series from 1986 to June 1991 is reported. Nowadays our group performs 70% of female genital benign lesions by the pelviscopic technique. Infect laparotomy has been abandoned in case of benign ovarian cyst while the pelviscopic myomectomy rate is about 69%. Our results show that this kind of management is safe and also undeniable advantages such as morbidity reduction, shorter hospital stay, less social cost, quick return to work and renewing of the method make the indications more and more every day.
The evolution of laparoscopic techniques has made possible the performance of myomectomies by pelviscopy. Our technique implies the incision of myometrium with diluted POR 8, the excision of myometrium by scissors and the removal of the myoma using a SEMM Enucleator, and finally the suture of one or two layers of the wound using a cylinder needle. The myoma is extracted from the abdominal cavity using sharp cylindrical morcellators. Our technique does not consider the use of monopolar or bipolar energy.